Every contact with your patient is an opportunity for health assessment. Ideal for quick reference, this pocket-sized guide puts all the crucial information at your fingertips. This second edition of Clinical Assessment provides an essential overview of the topic, including new material on assessment of the acutely ill patient and the older patient. The new edition also includes resources to aid accurate neurological assessment, specifically covering aspects such as delirium and dementia. Used as a platform for wider reading, it is an ideal reference point for any nursing and healthcare student or professional.

For counselor Nancy Wainer Cohen, this book is the sibling to "Silent Knife: Cesarean Prevention and Vaginal Birth after Cesarean "(Bergin & Garvey, 1983) her critically-acclaimed expose on America's growing reliance on cesarean sections. "Open Season "provides fresh insights and new information on the subject, offering guidance to childbearing couples, educators, health professionals, and scholars who value the natural path of childbirth.

Readers will find this book timely, informative, shocking, irreverent, and extremely readable. Cohen's intimate writing style presents a compendium of knowledge on childbirth in the fashion of a personal letter. Her aim is to lower America's alarming reliance on cesarean section, which is currently at 25 percent of all births, and to return the responsibility for childbirth to women by encouraging them to choose the kind of birthing experience they wish to have. In addition to cesarean section, Cohen discusses many other generally unnecessary interventions performed on women during pregnancy and childbirth--such as fetal monitoring and routinized hospital procedures.

Midwifery & Women's Health Nurse Practitioner Certification Review Guide, Fifth Edition is a comprehensive review designed to help midwives and women’s health nurse practitioners prepare for their certification exams. Based on the American Midwifery Certification Board (AMCB) and the National Certification Corporation (NCC) test blueprints, it contains numerous questions with answers and rationales representing those found on the exams. Completely updated and revised with the most current evidence and practice standards, the Fifth Edition incorporates expanded content on pharmacology, coverage related to LGBTQ+ individuals and racial minorities, more discussions of health disparities, and more practice questions and images throughout. Midwifery & Women's Health Nurse Practitioner Certification Review Guide, Fifth Edition is published in partnership with the American College of Nurse-Midwives (ACNM) and the National Association of Nurse Practitioners in Women’s Health (NPWH).

A new addition to the popular Midwifery Essentials series which continues to help readers understand and master a range of core issues safely and with confidence! Written by leading midwifery academics, each book in the series provides a user-friendly source of information which has been fully updated throughout to reflect the latest evidence-base for current practice. Now with an improved design to make learning as easy as possible, each paperback in the series focuses on the importance of communication and contemporary women-centred care and presents helpful 'scenarios' to encourage debate and reflection. The Midwifery Essentials series is ideal for all midwives - whether qualified or in training - and is also helpful to nurses and HCAs working in the maternity environment. Provides a useful, friendly source of information Strong focus on contemporary women-centred care Designed to stimulate debate and reflection upon current practice, local policies and procedures Scenarios enable practitioners to understand the context of maternity care and explore their role in safe and effective service provision Helpful 'jigsaw' approach enables readers to explore specific topics from a variety of perspectives e.g. consent, safety and health promotion Explains the professional and legal issues surrounding clinical procedures Chapters designed to be read as a 'standalone' or in succession Emphasises the crucial role of effective communication

Superpower your maternal-neonatal skills, with the fully updated Maternal-Neonatal Facts Made Incredibly Quick! (R), 3rd Edition , the indispensable pocket guide that offers at-your-fingertips answers on maternal-neonatal nursing essentials. Flip quickly to the section on which you need guidance with the help of brightly colored tabs. Then scan the quick-read bulleted text for vital direction on the four stages of labor, interpreting stress test results, Lamaze techniques, interpreting lab values, and more. This handy quick-reference guide offers both classroom and on-the-unit support for nursing students, nurses, and all maternal-neonatal healthcare professionals. Use this reference for maternal-neonatal assessments, tests, monitoring, and care, with these featues: NEW and updated bulleted content with quick-read tables, charts, and drawings Wipeable laminated pages that make notetaking and erasing quick and easy Pocket-sized, spiral-bound format that offers instant access to expert nursing guidance Dozens of colorful diagrams, charts, and images that offer practical direction for areas including: Classifying fetal presentation Distinguishing between true and false labor Noting systemic changes in the active phase of labor Assessing glucose challenge values Assessing the three categories of pregnancy signs Distinguishing the signs and symptoms of separation between the placenta and uterine wall Patient teaching Easy-to-follow definitions and guidance on areas including: Internal and external fetal monitoring-reading a fetal heart rate (FHR) monitoring strip and identifying FHR patterns Potential complications of medication administration Comfort measures in labor Primary indications for cesarean birth-maternal, placental, and fetal Understanding lacerations and umbilical cord prolapse Prenatal care - taking an obstretric and medical history, adaptations to pregnancy, fundal height, Leopold's maneuvers, fetal development, cultural practices, and more Intrapartum - spontaneous abortion, ectopic pregnancy, female pelvis, labor, cervical effacement and dilation, drug administration, cesarean birth, and more Postpartum - postpartum phases, fundal palpation, uterine involution, postpartal hemorrhage, pulmonary embolism, maternal self-care, lactation, and more Neonatal - neonatal flow algorithm, physiology and assessment, Apgar score, sutures and fontanels, infections, HIV, oxygen therapy, circumcision, neonatal labs, and more About the Clinical Editor Stephanie C. Evans, PhD, APRN, CPNP, is an Assistant Professor of Nursing at Texas Christian University in Fort Worth, Texas.

Maternal Newborn Nursing Care Plans, Third Edition teaches students and practicing nurses how to assess, plan, provide, and evaluate care for pregnancy, delivery, recovery, abnormal conditions, and newborn care. Featuring more than 65 of the most common and high-risk care plans for nursing care using the nursing process approach, it includes NIC interventions, discussions on collaborative problems, key nursing activities, signs and symptoms, and diagnostic studies. Using a progressive approach, the text begins with generic care plans that address all patient situations regardless of the patient diagnosis or condition before moving on to more complicated and specific care plans. The Third Edition offers new rationales for nursing actions based on scientific principles, a new breastfeeding care plan added to the normal newborn care chapter, new information on obesity in pregnancy, evidence-based practice boxes throughout to highlight current research, and updated references and research. Also included are new guidelines, practice changes, new standards, and evidence changes. * Consistent organization based on commonly encountered nursing diagnoses * Comprehensive coverage of normal pregnancy and common complications of pregnancy * Individualized and collaborative care plans cover both actual and potential problems and conditions * Content in concert with the Institute of Medicine's (IOM) mandate to improve the quality and safety of patient outcomes

This pocket-sized book, presented in an easy-to-follow format, is designed as a tool for students and professionals to carry in any setting, providing a quick reference guide to supporting women during labour. Used as a platform for wider reading, this text is an ideal reference point for any student or professional involved with the care of childbearing women.

'I love The Baby Feeding Book's no-nonsense, realistic, empowering and compassionate approach. It's a must-have book for all new parents' Rebecca Schiller, author of The No Guilt Pregnancy Plan From breastfeeding and bottle-feeding to giving solids, this is the only book you will need to feed your baby with confidence and without judgement, in the first year. The Baby Feeding Book is a unique, fascinating and holistic guide into the world of feeding babies and becoming a parent. Packed full of expert information, practical tips and true stories from parents, this book smashes through the myriad of myths and conflicting advice to detail everything any new parent wants to know, in order to help them make their own informed decisions and feed happily and successfully, according to their own goals. Vanessa Christie, international board-certified lactation consultant and mother of three, covers everything from the differences between breast and formula milk, building a confident mindset, being mindful of marketing strategies, boosting emotional wellbeing and understanding why babies behave the way they do. She also navigates the practical sides of feeding, such as how do you find the best breastfeeding position for you? When do you need to sterilise? How do you prevent mastitis? Should you top-up so baby sleeps longer? How do you store breastmilk? How do you choose a bottle? When should you give your baby nuts? And so much more... Sure to be a staple for every new parent, The Baby Feeding Book will be the indispensable and gentle guiding hand you need, whatever your pregnancy, birth and life throw at you.

The latest edition of the Survival Guide to Midwifery continues to offer readers with a wealth of information presented in a quick reference format which is perfectly tailored for use in the clinical environment. Fully updated throughout and now with new authorship, the book covers the core essentials of midwifery with topics that range from anatomy and reproduction, change and adaptation in pregnancy, antenatal care, clinical investigations, abnormalities and common medical problems. Other areas include obstetric emergencies, physical problems and complications in the puerperium, infant feeding, and the sick neonate. Now rebranded as Myles Survival Guide to Midwifery, this popular title will be ideal for midwives - whether qualified or in training - in all parts of the world. Helpful bullet point style allows rapid access to essential information Useful revision guide for examinations and assessments Contains common abbreviations, medications, drug calculations, glossary of common terms, and normal values Thoroughly revised to reflect key developments in current midwifery practice Now includes further reading and useful website addresses

The only book of its kind, Manual of High Risk Pregnancy & Delivery provides a complete resource for care of this special patient and her complex needs. It helps you provide positive outcomes with coverage of today's newest technology, physiologic considerations, psychologic implications, health disorders, and other complications in pregnancy. Written by noted educator and practitioner Elizabeth Stepp Gilbert, RNC, MS, FNP-BC, CNS, this book also describes how to screen for risk factors, provide preventive management, and intervene appropriately when problems arise. It's a concise, hands-on reference for both inpatient and outpatient settings! A consistent format makes this book a practical, hands-on reference in the clinical setting, presenting problems with the following headings: incidence, etiology, physiology, pathophysiology, and medical management. Comprehensive coverage includes physiologic considerations, fetal assessment, perinatal screening, ethical and legal issues, health disorders during pregnancy, complications, and labor and delivery issues. Up-to-date content includes integrative therapy, domestic violence, multiple gestation, genetics, nutrition, culture, risk management, and all the latest screening tools. A section on ethical and legal considerations covers ethical decision making, legal issues, and risk management. Updated evidence-based content includes the latest AHWONN standards of practice. Patient safety and risk management strategies include updated approaches to improving outcomes, reducing complications, and increasing patient safety during high risk pregnancy and delivery. New Venous Thromboembolic Disease chapter provides current information on this increasingly common condition. Information on the latest assessment and monitoring devices keeps you current with today's technology. Standardized terminology and definitions from the National Institute of Child Health & Human Development (NICHD) lead to accurate and precise communication.

'After the historic student revolt in France a period of audacious creativity resulted. The watchword was: "It is forbidden to forbid". We took advantage of this transient cultural folly to do what would have been impossible ten years before or ten years after, introducing in the maternity unit of a state hospital an inflatable outdoor pool as a way to replace drugs during birth.' - from the Introduction In this groundbreaking book, Dr Odent takes as his starting point the world-famous work on childbirth at Pithiviers, where he first noticed the strong attraction to water that many women have during labour. As well as discovering the practical advantages of water during the birthing process, he began to consider the meaning and importance of water as a symbol. Water, Birth and Sexuality examines the living power of water and its erotic connotations. Odent evaluates what water meant in different cultures throughout history, through myths and legends, and what it means for us today: from an advertiser's tool to a metaphor for aspects of the psyche. He also studies humanity's special relationship to dolphins, and the related 'aquatic ape' theory.A practical section on the use of water during birth and in various therapies, particularly sex therapy, is included. This edition of this classic work features a new Introduction.

Momente der Ergriffenheit erleben Frauen und Paare in der Zeit vom Kinderwunsch bis zum Wochenbett. Es sind Momente der Hoffnung, Gluckseligkeit, Krise, Entscheidung, Momente des Innehaltens oder des Abschiednehmens. Schwangerschaft, Geburt und Elternwerden sind sind mehr als nur physiologische ubergange, die eine medizinische Begleitung benoetigen. Der umfassende Lebensubergang kann eine spirituelle Dimension erreichen, nicht nur wenn unvorhergesehene Ereignisse existenzielle Krisen ausloesen. Das Buch richtet sich an alle Berufsgruppen, die in ihrer Arbeit Schwangere und werdende Eltern begleiten und in krisenhaften Situationen an ihre Grenzen stossen. Die Autorinnen und Autoren schoepfen dank ihrer Tatigkeiten, beispielsweise in der Aus- und Fortbildung von Hebammen und Beratenden, aus ihren vielfaltigen Erfahrungen. Sie bieten Anleitung zur spirituellen Begleitung bei Schwangerschaft und Geburt ebenso wie zum Erleben der eigenen spirituellen Kompetenz. Diese Kompetenz zum Einsatz zu bringen und Zugang zur eigenen Spiritualitat zu finden, ist Intention des Buches. Neben wissenschaftlichen Einfuhrungen und Erfahrungsberichten von Eltern und Begleitenden bieten neun Momente der Ergriffenheit Bildmeditationen sowie Impulse und Rituale als Inspirationen fur die eigene Praxis. Das Buch ist auf vielfaltige religioese sowie transreligioese Zugange hin angelegt.

Maria Anderson trained as an NHS nurse and went on to become a midwife, a job she has adored for over twenty years. After fainting whilst attending her first three births, Maria went from nervous trainee to assured midwife and in her brilliant memoir she recounts the highs and lows of life inside the maternity unit. From frantic fathers and breaking her hand during a traumatic home birth, to witnessing the delivery of quads and the ultimate devastation of assisting the delivery of a stillborn baby, Maria has had an extraordinary career. Tales of a Midwife is a funny, poignant and heart-warming account of a devoted midwife.

'I promised that I would one day write a book and tell the world about the home for unmarried mothers. I have at last kept my promise.' In Ireland, 1951, the young June Goulding took up a position as midwife in a home for unmarried mothers run by the Sacred Heart nuns. What she witnessed there was to haunt her for the next fifty years. It was a place of secrets, lies and cruelty. A place where women picked grass by hand and tarred roads whilst heavily pregnant. Where they were denied any contact with the outside world; denied basic medical treatment and abused for their 'sins'; where, after the birth, they were forced into hard labour in the convent for three years. But worst of all was that the young women were expected to raise their babies during these three years so that they could then be sold - given up for adoption in exchange for a donation to the nuns. Shocked by the nuns' inhumane treatment of the frightened young women, June risked her job to bring some light into their dark lives. June's memoir tells the story of twelve women's experiences in this home and of the hardships they endured, but also the kindness she offered them, and the hope she was able to bring.

The perfect companion to Safe Maternity & Pediatric Nursing Care, 2nd Edition! Each chapter in the Study Guide corresponds to a chapter in the text. Exercise by exercise, activity by activity, you'll develop your critical-thinking and problem-solving skills while mastering the principles, concepts, and procedures essential to success in the classroom and in practice.

Dr Grantly Dick-Read died on 11 June 1959. His teaching, however, gains a growing recognition even though others are putting their names to his theories and practices. The delivery on this recording was not in fact an 'easy' one, as the baby was not fully rotated. The record, therefore, not only justifies Dick-Read's teaching but is also a tribute to his own skill as a gynaecologist. The following sleeve notes were written a month after the recording. 'When my wife informed me that she was going to have a baby, I think my reactions were typical of most husbands. I was delighted, for we both wanted to start a family, but I was also anxious. My knowledge of childbirth was limited. I had heard that pregnancy could be 'difficult', that labour itself, if not actually dangerous, meant many hours of suffering either nobly endured or alleviated with anaesthesia. My wife, however, insisted that I read "Childbirth without Fear" by Dr Grantly Dick-Read. There I learned the simple tenets upon which his teaching is founded. The fear of childbirth can be overcome by simple instruction in the truth of natural processes. The methods by which a woman can help herself and not cause her own distress - correct breathing and relaxation for use during pregnancy and labour were explained. Simple exercises (requiring only a few minutes per day) to aid the general fitness for the birth of the baby were described. Dr Dick-Read stressed that even more important than the removal of pain is the spiritual joy the mother experiences when she sees her baby into the world, a joy, which transcends the moment of birth, and has a lasting influence on the family unity. This, as Dr Dick-Read says, is the experience, which is destroyed when the sensations of birth are removed or disturbed by interference. My wife decided that she would prepare for natural childbirth. It was at this point that as a recording executive I became involved professionally. My wife volunteered to have her labour recorded and Dr Dick-Read agreed to supervise her delivery and give a commentary as the labour proceeded. In effect, we had provided Dr Dick-Read with a test of some severity. We were not asking him to choose the best result from, say, twelve cases. The patient was not even selected by him. She was having her first baby and she was over thirty. Mrs Dick-Read began the antenatal preparation, as described in the book "Antenatal Illustrated". The voices you will hear on this record are those of Dr Dick-Read, Mrs Dick-Read, the expectant mother and, towards the end of the record, a woman doctor in general practice who assisted Dr Dick-Read. Another doctor who was present primarily as an interested observer was also skilled in the administration of pain relief should the patient have desired it. A bedroom in Dr Dick-Read's house in Petersfield had been equipped with a labour bed. Trilene and Pethedine were available; for, contrary to some reports, a strongly maintained principle of Dr Dick-Read's teaching was that the patient should not be expected to suffer any unnecessary pain or discomfort. Three microphones were used. One was placed above the bed and used to pick up conversations between doctor and patient and also the atmosphere of the ward, which was calm and peaceful throughout. At each side of the bed we placed microphones for use when either Dr or Mrs Dick-Read wished to make any comment. I personally operated the recording equipment in an adjoining room during the confinement and can categorically state that at no time did I feel that my wife was asked to bear any severe discomfort. Even when owing to the incomplete rotation of the baby's head at the outlet, and in order to prevent unnecessarily prolonging the final stage of labour, a small incision was made, my wife did not feel this and did not at any stage request anaesthetic. That she was asked to do a lot of very hard work she will be the first to admit. But the joy of the birth itself is unforgettable. During the early stages of her labour I was with her and able to help during her contractions with the back-rubbing, she found so beneficial at this stage. A swishing sound on the record during the first stage contractions is made by this back-rubbing. It is during this stage that Dr Dick-Read insisted that all patients should have company. So often the expectant mother is 'left to get on with it until the second stage is reached. During the second stage considerable background noise is caused by the movement of the bed-clothes when the patient changes her position in order to use her contractions efficiently. The recording was made on tape, edited and then transferred to a long playing record. Before we started to condense the recording of a twelve-hour labour to the length of one LP record we invited reporters to hear parts of the as yet uncut tape, including the last twenty minutes. It was pointed out to them that although a very heavy task of selection lay ahead, there was nothing which needed to be suppressed for the purpose of demonstrating natural childbirth. The editing presented two major problems. Owing to the fact that our microphones were highly sensitive in order to pick up the quietly and calmly conducted comments and discussions of the doctor, his patient and his assistants, we also picked up many unwanted and distracting noises, doors closing, sterilised tins being opened, running taps, etc. These noises have been removed wherever possible from the finished record. Condensation proved more difficult, for many of the early stage contractions were very similar, and throughout the first two stages there were long periods when the patient was lying peacefully relaxed between her contractions. All that was merely repetitious or irrelevant had to be discarded. To present a twelve-hour labour on one long playing record was clearly impossible, therefore we were faced with a further problem. If we did not include some passages of rest and relaxation, we would give an impression that the patient moved rapidly from contraction to contraction; but to allow a five-minute rest its full playing time was not possible. We have tried, therefore, to maintain the impression of the overall rhythm of labour by selection of contractions and the shortening of silences. We have not condensed individual contractions. This is important in demonstrating the breath control called for during contractions. This record, then, is an account of a twelve-hour labour leading up to the dramatic moments when the baby is born. One of the most outstanding moments on this record occurs towards the end of the first side. Using his stethoscope with a microphone placed alongside it, Dr Dick-Read searches for and listens to the heart-beat of the baby while it is still in the birth canal, one hour and a half before it is born-an exciting moment for the recording technicians and the doctors when they heard the playback for the first time. Reporting on the last twenty minutes of this recording, one of Britain's leading newspapers, the "Daily Mirror", called it: "The most moving record I have ever heard". If this record helps to abolish fear, it will help to abolish pain in labour. If it helps to spread the teachings of Dr Grantly Dick-Read, then it will have done its job. His work won its due recognition when it was acknowledged and approved by His Holiness, Pope Pius XII, who also commented upon the spiritual approach inherent in Dr Dick-Read's method, saying: "The researches of the Englishman, Dr Grantly Dick-Read, differed notably from those of the Russians (notably the followers of I.P. Pavlov) in their philosophical and metaphysical postulates which were not based, like those of the Russians, on materialistic concepts". This record should help to prepare a woman for the emotional and spiritual experience which is her right, and needs to be fought for, just as much as her right to highly skilled surgery, or pain-killing drugs. There is still some opposition to Dr Dick-Read's work, especially in his own country; there are many places where lip-service is paid to his system; but if his method is followed sincerely by those responsible for the conduct of labour, the result can be as on this record. Here, then, unscripted and unrehearsed, is a record of a natural childbirth.' H.J.U.

Safeguarding and protecting the welfare of children is a statutory duty for all nurses and midwives. This book helps equip student nurses and midwives with the confidence, knowledge and skills needed for working with families to support and protect children. It covers the full spectrum of safeguarding work, from professional issues such as boundaries and confidentiality through to attachment and communication.

Key features:

-A clear explanation of the policy and key theories informing safeguarding work. -Consideration of the common challenges you are likely to face, such as vulnerability in pregnancy, domestic violence and parenting capacity. -Reflective activities and case histories which help you to develop and enhance your own practice.

The book also considers multi-agency working and includes important coverage on professional issues like boundaries, confidentiality, referral and accountability. Written with clarity and accuracy, the authors have produced an important resource suitable for any nurse or midwife preparing to work with children and families.

This groundbreaking book takes us around the world in search of birth models that work in order to improve the standard of care for mothers and families everywhere. The contributors describe examples of maternity services from both developing countries and wealthy industrialized societies that apply the latest scientific evidence to support and facilitate normal physiological birth; deal appropriately with complications; and, generate excellent birth outcomes - including psychological satisfaction for the mother. The book concludes with a description of the ideology that underlies all these working models - known internationally as the midwifery model of care.

2021 Honorable Mention for the Association for Feminist Anthropology's Rosaldo Book Prize Maternal health outcomes are a key focus of global health initiatives. In Delivering Health, author Lydia Z. Dixon uncovers the ways such outcomes have been shaped by broader historical, political, and social factors in Mexico, through the perspectives of those who are at the front lines fighting for change: midwives. Midwives have long been marginalized in Mexico as remnants of the country's precolonial past, yet Dixon shows how they are now strategically positioning themselves as agents of modernity and development. Midwifery education programs have popped up across Mexico, each with their own critique of the health care system and vision for how midwifery can help. Delivering Health ethnographically examines three such schools with very different educational approaches and professional goals. From San Miguel de Allende to Oaxaca to MichoacAn and points between, Dixon takes us into the classrooms, clinics, and conferences where questions of what it means to provide good reproductive health care are being taught, challenged, and implemented. Through interviews, observational data, and even student artwork, we are shown how underlying inequality manifests in poor care for many Mexican women. The midwives in this book argue that they can improve care while also addressing this inequality. Ultimately, Delivering Health asks us to consider the possibility that marginalized actors like midwives may hold the solution to widespread concerns in health.

Supporting a Physiologic Approach to Pregnancy and Birth: A Practical Guide provides an overview of current evidence and a range of practical suggestions to promote physiologic birth within the United States healthcare system. Presenting the latest evidence available on practical approaches and minimal interventions, this book looks into clinic exam rooms and hospital labor units to investigate the possibilities for improving the pregnancy and labor experience. Contributors discuss recent research and other published information and present a range of ideas, tools, and solutions for maternity care clinicians, including midwives, nurses, physicians, and other members of the perinatal team. An invaluable resource, Supporting a Physiologic Approach to Pregnancy and Birth is a must-have practical guide for those involved in all aspects of pregnancy and birth.

This book informs and enlighten health professionals on how the recognition of fearing women can change their episode of care during childbearing. It gives practical advice on the way women present to services and the challenges that this invokes. This work is the first of its kind aimed at clinicians to deconstruct ideology around childbearing myths and its challenges. The authors review the evidence that exists and how modern maternity systems are responding to fear and shaping healthcare. Whilst some worry and anxiety is expected and indeed considered normal during childbearing, it has been suggested that this has now proliferated to a degree of abnormal for many women. Why is that and how is this panic spread? Media portrayal of birth is suggested as unrealistic material and to show only that which is dramatic and horrific. This has been considered as one factor influencing modern women. Medicalisation, technology and demand upon services is another consequence of providing almost all maternity care in hospitals. Given that the majority of childbearing women are fit and healthy is this another causative factor? By removing women from their homes and families at such a vulnerable time has a serious consequence for how she will experience her greatest leap of faith into motherhood. All of these issues are explored and examined in the book with ideas and practical suggestions of what may be done to change this increasingly common problem. This book is intended at midwives and clinicians working in maternity settings.

Highly detailed and clearly written, this book is the first full-length study of the complex system of practices, beliefs and taboos which surrounded conception and childbirth in early modern Europe.
In a rich and scholarly study, Jacques Gelis reconstructs the activities and attitudes of the midwives and mothers, and the sufferings they had to endure. He continues with an examination of the role of the Church, the herbalist and the mineral world (touchstones and talisman) in the explanation of the mysteries of procreation.

As Puerto Rico rapidly industrialized from the late 1940s until the 1970s, the social, political, and economic landscape changed profoundly. In the realm of heath care, the development of medical education, new medical technologies, and a new faith in science radically redefined childbirth and its practice. What had traditionally been a home-based, family-oriented process, assisted by women and midwives and "accomplished" by mothers, became a medicalized, hospital-based procedure, "accomplished" and directed by biomedical, predominantly male, practitioners, and, ultimately reconfigured, after the 1980s, into a technocratic model of childbirth, driven by doctors' fears of malpractice suits and hospitals' corporate concerns. Pushing in Silence charts the medicalization of childbirth in Puerto Rico and demonstrates how biomedicine is culturally constructed within regional and historical contexts. Prior to 1950, registered midwives on the island outnumbered registered doctors by two to one, and they attended well over half of all deliveries. Isabel M. Cordova traces how, over the next quarter-century, midwifery almost completely disappeared as state programs led by scientifically trained experts and organized by bureaucratic institutions restructured and formalized birthing practices. Only after cesarean rates skyrocketed in the 1980s and 1990s did midwifery make a modest return through the practices of five newly trained midwives. This history, which mirrors similar patterns in the United States and elsewhere, adds an important new chapter to the development of medicine and technology in Latin America.